Individual
MR. BRIAN PATRICK GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
573 BUSH ST, DEKALB, IL 60115-4018
(630) 291-6106
Mailing address
573 BUSH ST, DEKALB, IL 60115-4018
(630) 291-6106
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.007326
IL
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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